This invention pertains to the treatment of inguinal hernias via the peritoneoscopic route. More specifically, the invention relates to apparatus for the installation of a prosthesis in the abdominal cavity in the implementation of this treatment.
Inguinal hernias result from the passage of intra-abdominal organs to the outside of the abdominal cavity, passing through the muscular wall. This abnormal passage stems from a defect which can be congenital or acquired. Inguinal hernias are very common disorders, such that surgical interventions for repairing these defects are at present among the most frequently performed operations.
There are two problems related to the repair of inguinal hernias: their frequency and the rate of recidivism after treatment. An imperfect operative technique results in a high recidivism rate with the associated human and social consequences (repeated surgical interventions, increased costs).
There has been an ongoing attempt to improve the surgical techniques applied to the treatment of inguinal hernias to decrease the recidivism rate and, above all, to allow patients to resume their social and professional activities as quickly as possible.
It turns out that in the majority of acquired hernias, the most reliable treatment involves installation of a prosthesis, i.e., an element made of a foreign material which, by inducing intense fibrosis, is the agent of repair. The problems associated with the prosthetic material entail its tolerance as well as its installation. Considerable progress has already been achieved both with regard to the material used for the prosthesis as well as its installation. The peritoneoscopic route is the least invasive possible technique as well as the best tolerated.
At present, the prosthetic material is installed via the peritoneoscopic route by introduction inside a trocar. Although this represents definite progress for the patient as well as for the surgeon, it is undeniable that the existing systems still have drawbacks.
Because the conventional dimension of the prosthesis is typically 13xc3x9710 cm, it is necessary to roll the prosthetic element like a cigarette to be able to introduce it via a trocar. It is tedious to have to unroll this element after it has been introduced into the interior of the abdominal cavity and then to maintain it in the correct position so that it can be stapled. Thus, it would be advantageous to provide an apparatus which facilitates the introduction, installation and stapling of such an element inside the abdominal cavity.
This advantage is attained according to the invention which provides an apparatus enabling the introduction with increased ease of a prosthesis of the previously mentioned type in pad form into the interior of the abdominal cavity and to automatically unroll it, such that its installation and stapling are easier for the practitioner. More specifically, the invention includes a device for the installation of a prosthesis in the treatment of inguinal hernias via peritoneoscopy, comprises:
an applicator essentially constituted of a substantially cylindrical tube capable of containing the prosthesis and of a plunger for injecting the prosthesis from the tube at the desired site, and
a spring attached to the plunger such that it is capable of attaching to the prosthesis in a detachable manner and of spreading it out when it is discharged to the exterior of the tube.